title: Cardiac response to early conversion from calcineurin inhibitor to everolimus in renal transplant recipients: an echocardiographic substudy of the randomized controlled CENTRAL trial.
abstract: BACKGROUND
  Calcineurin inhibitors are associated with adverse cardiac effects. Mammalian target of rapamycin inhibitors have been reported to have beneficial effects on cardiac function. We used advanced echocardiographic techniques in a randomized controlled trial to examine cardiac responses to an everolimus-based arm versus a calcineurin inhibitor-based arm in de novo kidney transplant recipients.
  
  
  METHODS
  This was a substudy of the Certican Nordic Trial in Renal Transplantation study, a randomized controlled trial on safety and efficacy of early (week 7 after renal transplantation) conversion from cyclosporine A (CsA) to everolimus versus continued CsA during 1-year follow-up. A total of 44 patients (66% men; median [range] age, 61 [28-78] years) were included. All participants had a complete echocardiographic evaluation at baseline and at 1-year follow-up.
  
  
  RESULTS
  Left ventricular (LV) systolic function, LV mass, left atrial volumes, and blood pressure response did not differ between groups during 1-year follow-up. There was, however, a difference between the groups in change in peak early mitral velocity after 1 year (P=0.02), and E/e' ratio trended higher in the everolimus group (P=0.09).
  
  
  CONCLUSIONS
  Early conversion from CsA-based to everolimus-based immunosuppressive treatment in de novo renal transplant recipients caused marginal changes in LV diastolic function but no effect on LV systolic function or LV mass.
authors.affiliation: 1 Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. 2 Departments of Nephrology and Transplant Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. 3 Department of Medicine, Baerum County Hospital, Baerum, Norway. 4 Address correspondence to: Klaus Murbraech, M.D., Department of Cardiology, Oslo University Hospital, Rikshospitalet, Pb 4950 Nydalen, 0424 Oslo, Norway.
authors.forename: Klaus
authors.initials: K
authors.lastname: Murbraech
authors.forename: Hallvard
authors.initials: H
authors.lastname: Holdaas
authors.forename: Richard
authors.initials: R
authors.lastname: Massey
authors.forename: Liv H
authors.initials: LH
authors.lastname: Undset
authors.forename: Svend
authors.initials: S
authors.lastname: Aakhus
mesh_terms: D000328:Adult; D000368:Aged; D065095:Calcineurin Inhibitors; D003971:Diastole / Q000187:drug effects; D004452:Echocardiography; D000068338:Everolimus; D005260:Female; D006321:Heart / Q000187:drug effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives*; D013599:Systole / Q000187:drug effects
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus